<!DOCTYPE html>
<html>

<head>
	<meta charset="utf-8" />
	<title>略略</title>
	<meta name="keywords" content="desktop">
	<meta name="description" content="desktop">
	<meta name="renderer" content="webkit|ie-comp|ie-stand">
	<meta http-equiv="X-UA-Compatible" content="IE=edge,chrome=1">
	<meta name="viewport" content="width=device-width, initial-scale=1, maximum-scale=1">
	<link rel="stylesheet" type="text/css" href="../../css/bootstrap.css" />
	<link rel="stylesheet" href="../../css/index.css" />
	<script type="text/javascript" src="../../js/jquery-2.1.0.js"></script>
	<script src="../../js/bootstrap.min.js" type="text/javascript" charset="utf-8"></script>
</head>

<body>

	<!-- 窗体主内容 -->
	<div class="modal-body">
		<div class="tahtmul modderlis">
			<div class="row">
				<div class="form-group">
					<label class="control-label col-md-5 text-right">商户名称 :</label>
					<div class="col-md-7">
						<input type="text" class="form-control input-sm" placeholder="商户名称">
					</div>
				</div>
			</div>
			<div class="row">
				<div class="form-group">
					<label class="control-label col-md-5 text-right">商户地址 :</label>
					<div class="col-md-7">
						<input type="text" class="form-control input-sm" placeholder="商户地址">
					</div>
				</div>
			</div>
			<div class="row">
				<div class="form-group">
					<label class="control-label col-md-5 text-right">省份 :</label>
					<div class="col-md-7">
						<select class="form-control">
									<option>省份</option>
									<option>广东</option>
									<option>湖南</option>
					</select>
					</div>
				</div>
			</div>
			<div class="row">
				<div class="form-group">
					<label class="control-label col-md-5 text-right">城市 :</label>
					<div class="col-md-7">
						<select class="form-control">
									<option>城市</option>
									<option>广州</option>
									<option>广西</option>
					</select>
					</div>
				</div>
			</div>
			<div class="row">
				<div class="form-group">
					<label class="control-label col-md-5 text-right">经营范围 :</label>
					<div class="col-md-7">
						<select class="form-control">
									<option>五金</option>
									<option>螺丝</option>
					</select>
					</div>
				</div>
			</div>

			<div class="row">
				<div class="form-group">
					<label class="control-label col-md-5 text-right">联系人 :</label>
					<div class="col-md-7">
						<input type="text" class="form-control input-sm" placeholder="联系人">
					</div>
				</div>
			</div>

			<div class="row">
				<div class="form-group">
					<label class="control-label col-md-5 text-right">联系方式 :</label>
					<div class="col-md-7">
						<input type="text" class="form-control input-sm" placeholder="联系方式">
					</div>
				</div>
			</div>

		</div>
	</div>
	<!-- 窗体主内容 -->

</body>


</html>